急性感染性腹泻患者护理需求调查

目的了解急性感染性腹泻患者的护理需求,为制定护理规范和健康教育手册提供依据。方法以168例急性感染性腹泻患者为对象,采用自制问卷调查其住院期间生理、心理、社会及经济等方面的需求。结果急性感染性腹泻患者在住院期间的需求是多方面的,其中处于前3位的是护理人员及时准确实施各项治疗、了解自己当前病情、护理人员仔细观察病情;年龄、腹泻次数、体温及有无基础疾病与护理需求呈正相关(均P0.05),月收入、住院次数与护理需求呈负相关(均P0.05)。结论应及时了解和满足急性感染性腹泻患者的护理需求,根据患者不同年龄、腹泻次数、体温等给予针对性护理,以促进疾病恢复。     

鹿茸多肽诱导自体骨髓间质干细胞移植修复兔膝关节软骨缺损

目的探讨经鹿茸多肽(PAP)诱导的兔自体骨髓间质干细胞(MSCs)复合胶原膜(MCMG)对兔膝关节局部全层软骨缺损的修复作用。方法新西兰大白兔随机分成A,B,C3组,A组以PAP诱导后的自体MSCs和MCMG修复软骨缺损;B组以经转化生长因子β1(TGF-β1)诱导后的自体MSCs和MCMG修复软骨缺损;C组以自体MSCs和MCMG修复软骨缺损。分别于术后2、4和8周取材进行大体、组织学及免疫组织化学染色观察,根据关节软骨组织学计分标准进行评分。结果对术后8周大体及各阶段组织学形态评分结果显示:A组与B组修复差别无统计学意义(P>0.05),而A、B组明显优于C组(P<0.05)。结论经PAP诱导的兔自体MSCs/MCMG支架复合物可促进软骨缺损的快速修复,恢复软骨组织的结构和功能。     

甲状腺手术显露喉返神经的临床研究

目的探讨甲状腺手术时显露喉返神经(RLN)对预防RLN损伤的作用。方法分析810例甲状腺手术中252例甲状腺手术中显露RLN(甲组)和558例术中未显露RLN(乙组)患者的临床资料。结果虽然甲组甲状腺手术切除范围大于乙组;但甲组RLN损伤发生率(1.19%)明显低于乙组(3.05%)(P<0.01)。结论甲状腺手术时有选择地显露喉返神经,可明显降低喉返神经损伤发生率。     

Maslinic acid suppresses osteoclastogenesis and prevents ovariectomy‐induced bone loss by regulating RANKL‐mediated NF‐κB and MAPK signaling pathways

Activation of NF‐κB and MAPK/activator protein 1 (AP‐1) signaling pathways by receptor activator NF‐κB ligand (RANKL) is essential for osteoclast activity. Targeting NF‐κB and MAPK/AP‐1 signaling to modulate osteoclast activity has been a promising strategy for osteoclast‐related diseases. In this study we examined the effects of maslinic acid (MA), a pentacyclic triterpene acid that is widely present in dietary plants, on RANKL‐induced osteoclastogenesis, osteoclast function, and signaling pathways by in vitro and in vivo assay systems. In mouse bone marrow monocytes (BMMs) and RAW264.7 cells, MA inhibited RANKL‐induced osteoclastogenesis in a dose‐dependent manner within nongrowth inhibitory concentration, and MA decreased osteoclastogenesis‐related marker gene expression, including TRACP, MMP9, c‐Src, CTR, and cathepsin K. Specifically, MA suppressed osteoclastogenesis and actin ring formation at early stage. In ovariectomized mice, administration of MA prevented ovariectomy‐induced bone loss by inhibiting osteoclast activity. At molecular levels, MA abrogated the phosphorylation of MAPKs and AP‐1 activity, inhibited the IκBα phosphorylation and degradation, blocked NF‐κB/p65 phosphorylation, nuclear translocation, and DNA‐binding activity by downregulating RANK expression and blocking RANK interaction with TRAF6. Together our data demonstrate that MA suppresses RANKL‐induced osteoclastogenesis through NF‐κB and MAPK/AP‐1 signaling pathways and that MA is a promising agent in the treatment of osteoclast‐related diseases such as osteoporosis. © 2011 American Society for Bone and Mineral Research.     

Colles骨折合并舟骨月骨分离

目的 探讨Colles骨折合并舟月骨分离的治疗方法。方法 对40例Colles骨折合并舟月骨分离的患者,采用适当地延长对抗牵引时间和闭合手法复位,整复后以中立位、轻度背伸位固定治疗。结果 经6-18个月的随访。40例患者全部获得骨性愈合,根据腕关节运动功能综合评定,优23例,良12例,可5例,优良率达86.9%。结论 舟月骨分离是腕不稳定的主要因素。治疗首先要力争使骨折复位,纠正腕关节的动力性不稳定,同时要恢复舟月骨间的正常解剖关系。传统的掌屈尺偏位固定。石油利于改善腕关节不稳定状态。     

系统健康教育对风湿性心脏病手术患者的影响

目的探讨系统健康教育对风湿性心脏病手术患者康复的影响。方法将102例风湿性心脏病行心脏瓣膜置换术的患者按住院号奇偶数分为观察组和对照组，各51例。对照组采用常规健康教育，观察组采用系统健康教育，即遵循系统化、互动化、全程化、个体化、重点化原则，分住院一、二、三阶段及出院前4阶段教育，并根据患者反馈及时调整教育内容及形式。教育形式有口授式讲解、谈心式调查、一对一个别宣教、召开患者座谈会及口试反馈等。结果与对．照组比较，观察组遵医行为改善更为显著（P〈0.01）；肺部并发症发生率显著降低（P〈0.05）；住院患者满意度显著提高（P〈0.01）；出院后3个月PT延长率显著下降（P〈0．01）。结论系统健康教育能提高患者对疾病的认知水平，改善患者的遵医行为；提高患者的自我保健意识和能力，降低并发症的发生率；密切护患关系，提高患者的满意度。     

3种肠道清洁方法效果比较

目的探讨不同肠道清洁方法用于放大肠镜检查与治疗的效果。方法将1296例接受放大肠镜检查与治疗的患者随机分成甘露醇组（378例）、复方聚乙二醇电解质散组（431例）和大肠水疗组（487例），分别采用口服甘露醇、口服复方聚乙二醇电解质散和大肠水疗法进行肠道准备。比较肠道清洁效果和恶心、呕吐、腹痛等不良反应的发生率。结果大肠水疗组和复方聚乙二醇电解质散组的肠道清洁有效率显著高于甘露醇组（均P〈0．0125）；三组恶心、呕吐发生率比较，差异有显著性意义（均P〈0．0125）。结论大肠水疗法的肠道清洁效果明显优于口服甘露醇，不良反应少，但费用较高；复方聚乙二醇电解质散肠道清洁效果与大肠水疗法相似，不良反应相对少。应根据患者的实际情况及经济能力选择最佳的肠道准备方法。     

Reactive Oxygen Species Play a Biphasic Role in Brain Ischemia

Objective: Reactive oxygen species (ROS) are the essential mechanism involving in the ischemic process. Due to their complex characteristics, the precise effects of ROS on post-ischemic neurons remain uncertain. This study aimed to investigate the potential role of ROS in brain ischemia. Methods: Dynamic ROS levels in the perifocal cortex were evaluated after right middle cerebral artery occlusion (MCAO) of SD rats. Furthermore the role of ROS was assessed following delayed treatment with the ROS scavenger dimethylthiourea (DMTU) after brain ischemia. Results: ROS levels markedly increased at 1 hr after reperfusion and then gradually decreased as the post-reperfusion time interval increased. ROS levels reached their lowest point at 3 days after reperfusion before increasing and showing a second peak at 7 days after reperfusion. ROS levels negatively correlated with neurological function scores. Delayed DMTU treatment after stroke worsened neurological outcomes, decreased microvessel density and inhibited stress-activated protein kinase activation. Conclusion: ROS may play a biphasic role in cerebral ischemia. Namely, ROS may induce damage during the injury phase of brain ischemia and participate in improving neurological function during the recovery phase.     

噬菌体展示肽库技术在胃癌研究与治疗中的进展

胃癌(Gastric cancer)是我国最常见的消化道肿瘤之一。近几年,胃癌早期诊断以及低副作用的有效治疗已经成为研究人员重点关注的方向和领域。噬菌体展示肽库技术 (phage display library, PDL)作为分析蛋白质之间相互作用的有效方法,具有简便、高效、高通量等优点,这使得PDL在胃癌的诊断检测和靶向治疗领域展示出了极大的研究价值和潜力。本文就目前PDL技术在胃癌诊断和治疗领域中的研究进展进行综述。